Blood exchanging apparatus and process

ABSTRACT

In a blood exchanging apparatus useful for automatically withdrawing deleterious blood from the body, discharging said blood, and supplying a like quantity of specified blood for infusion into the bloodstream of the body, a syringe is coupled to a valve that includes a series of ports that provide passage for accomplishment of the foregoing select blood transferring functions, with the plunger of said syringe connecting with a carriage that threadedly engages to a feed screw that may be selectively turned in either direction by means of a reversing motor, with the turning of said motor being reversible by means of the actuation of limit means or switches that are functionally disposed to said feed screw and operative through the movements of said carriage for effecting their select actuation and reversal of said motor and feed screw. The valve is also sequentially set to provide for the select movements of blood into or from the syringe, and to achieve this a gear means connecting to said valve is turned by means of a drive means, such as a rack and pinion, that are actuated by a solenoid which is regulated in its functioning by means of the aforesaid limit means or switches. In the process of exchanging of blood through the use of the aforesaid device, the passages of the valves are set to coordinate with the functioning of the plunger within the syringe, so that in its first setting blood may be withdrawn from the body, and then discharged through a second setting of said valve, with the valve then being adjusted to provide for the drawing of specified blood into said syringe which may then be infused into the bloodstream of the body through a final adjustment and setting of said valve. All of these functions are coordinated through the circuit relationship between the alternate movements of the syringe means by operation of the feed screw, which operations are changed through actuation of the switch means, which also signals the timed operation of the solenoid and its interconnected gear and valve means so that selective passages of said valve may be opened in sequence with the operations of said syringe.

United States Patent Guenther 1451 Oct. 31, 1972 l54l BLOOD EXCHANGING APPARATUS AND PROCESS Harvey C. Guenther, 325 Main Street, OFnllon, 111. 62269 [22] Filed: July 28, 1970 [21] Appl. No.: 58,829

[72] Inventor:

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Primary ExaminerDalton L. Truluck Attorney-Paul M. Denk [57] ABSTRACT In a blood exchanging apparatus useful for automatically withdrawing deleterious blood from the body, discharging said blood, and supplying a like quantity of specified blood for infusion into the blood stream of the body, a syringe is coupled to a valve that includes a series of ports that provide passage for accomplishment of the foregoing select blood transferring functions, with the plunger of said syringe connecting with a carriage that threadedly engages to a feed screw that may be selectively turned in either direction by means of a reversing motor, with the turning of said motor being reversible by means of the actuation of limit means or switches that are functionally disposed to said feed screw and operative through the movements of said carriage for effecting their select actuation and reversal of said motor and feed screw. The valve is also sequentially set to provide for the select movements of blood into or from the syringe, and to achieve this a gear means connecting to said valve is turned by means of a drive means, such as' a rack and pinion, that are actuated by a solenoid which is regulated in its functioning by means of the aforesaid limit means or switches.

in the process of exchanging of blood through the use of the aforesaid device, the passages of the valves are set to coordinate with the functioning of the plunger within the syringe, so that in its first setting blood may be withdrawn from the body, and then discharged through a second setting of said valve, with the valve then being adjusted to provide for the drawing of specified blood into said syringe which may then be infused into the bloodstream of the body through a final adjustment and setting of said valve. All of these functions are coordinated through the circuit relation- $n215" 3el2%1l8l?1% 1213823213. 8111121. 552 tions are changed through actuation of the switch means, which also signals the timed operation of the solenoid and its interconnected gear and valve means so that selective passages of said valve may be opened in sequence with the operations of said syringe.

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BLOOD EXCHANGING APPARATUS AND PROCESS BACKGROUND OF THE INVENTION This invention relates to an apparatus for automatically exchanging of human blood in the body, and has particular utility in the treatment of the blood diseases of the infant wherein the exchange of deleterious blood with a supply of medically specified blood is gradually performed over an increment of time.

In the treatment of blood diseases, particularly in the treatment of blood diseases of the child, it has become standard practice to actually exchange the toxic blood rather than attempt to achieve a solution to the problem by treating the blood intact within the body. For example, in the treatment of hemolytic disease of the newborn, which is now performed through an exsanguinatious transfusion, ordinarily a donor of heparinized blood will be available to hopefully supply the needed quantity of blood to be infused into the bloodstream of the baby. To facilitate this function many prior art blood transfusion devices have been devised which function selectively to either remove septic fluids from the body, with the subsequent transferral of blood fluids into the body. For example, in United States Pat. No. 1,481,794, an apparatus is disclosed for performing a straight blood transfusion operation wherein the flow tubes of the apparatus are connected to both the donor and the recipient and through a motor actuated cam and pump arrangement, provide for the continuous pumping of blood from the donor to said recipient. This apparatus is significant for showing one of the early type transfusion devices, but it does not incorporate the further significant feature or step in its processing, nor the mechanical means for performing, the concept of first removing toxic blood from the recipient before medically specified blood is infused into the recipient's body. Although, it is to be noted, this prior art patent at least recognized that the arrangement of its flow tubes could be reversed so that septic fluids could be removed from the body.

The concept of actually providing for the exchange of blood in the body through a mechanical apparatus is of more recent origin, and U.S. Pat. No. 3,098,480, discloses. one system for performing this operation wherein this mechanical apparatus incorporates a combination of a series of pumps and valves that coordinate the withdrawal of blood while at the same time transmitting compatible blood into the vascular system of the body. it is noteworthy that the prior art as described in this previous patent recognized the handling of this basic process by manual operation of a pumping system comprising the use of glass syringes and two three-way stop cocks. in any event, this prior invention contemplates the performance of the exchange transfusion process through the simultaneous action of two pumps, a single valve, and a series of four vessels for either permanent or temporary storage of withdrawn and donor blood.

Also of more recent origin is U.S. Pat. No. 2,842,l24, which discloses this manually operative blood transfusion system which incorporates in combination a syringe and multipassageway cylinder which may be functioned to withdraw diseased blood from an infant, with the subsequent infusion of the donors blood into the body. This prior art invention is significant in showing the use in combination of a cylinder, or fluid control device, with a syringe. 0n the other hand, the essence of this present device is a totally mechanically functioning type device to perform the blood exchange transfusion process so that a series of doctors and nurses need not be occupied during the entire exchanging period.

Another prior art patent, U.S. Pat. No. 2,498,672, discloses a motor drive for a medical syringe or hypodermic needle.

It is a principal object of this invention to provide a motor actuated syringe which functions in sequence with the setting of a connecting valve to completely automate the process of exchange transfusion of blood.

It is another object of this invention to provide for the sequential performance in the act of blood exchanging to effect first a withdrawal of deleterious blood from the recipient's body. discharging said blood, and then supplying new blood for infusion into the body all through the efforts of a mechanized actuated medical syringe.

It is an additional object of this invention to provide a blood exchanging device which does not require the services of medical personnel during its operation after the initial set up phase has been completed.

It is yet another object of this invention to provide a blood exchanging device wherein the resetting of a valve for diverting blood to and from various sources is achieved in coordination with the limited movements of a motor actuated syringe.

It is a further object of this invention to provide a blood exchanging device wherein the blood directional control valve is disposable thereby enhancing the degree of sanitation maintained in the use of this device.

Another object of this invention is to provide a process for performing the exchanging of blood in the body, which process is totally automatic due to the cooperation of interengaging components that are mechanically manipulated for achieving timed settings to perform the sequence of operations necessary to effect a complete blood exchange.

Other objects will become apparent to those skilled in the art in the light of the following summary and description of the preferred embodiment.

SUMMARY OF THE INVENTION In the proper performance of the exchanging of blood, it is essential that small increments of blood be removed from the vascular system of the body, and with the replacement of said blood with like quantities of the medically specified blood as received from a donor source. To achieve this function, this invention contemplates the use of the medical syringe, being converted in some aspects, with the usual gradation lines indicating the number of cubic centimeters or quantity of blood that may be withdrawn or infused from and into the blood stream of the body. The syringe is stably mounted upon the framework of the device so that its internal, longitudinally slidable plunger may be withdrawn and inserted alternately to effect these fluid handling sequences. The syringe plunger is coupled to a carriage which is mounted by means of a roller for longitudinal movement simultaneous with the movement of said syringe plunger. This carriage is threadingly mated to a feed screw that is disposed for turning in either direction by means of a reversible motor, so that the turning of said screw in one direction provides for movement of said plunger further into the syringe, while the reversing of said motor and feed screw effects a withdrawal of the plunger from its syringe. Through this alternate action, blood fluid may be drawn into or discharged from the syringe, during accomplishment of this exchange. To further stabilize the movement of the carriage with respect to the feed screw, or by means of the feed screw, a rod is arranged parallel and adjacent to the feed screw, and said carriage is pivotally mounted to said rod and capable of sliding movement thereupon. Said rod is spring mounted upon the framework of the device, and is capable of slight longitudinal movement against the bias of its springs in either direction particularly when the carriage encounters one or the other of adjustable stops that are secured to said rod and which are useful for setting the limits of movement of said plunger within its syringe, thereby controlling the quantity and capacity of fluid handled during each cycle of the exchange operation. Microswitches are mounted proximate either end of this rod, so that the slight longitudinal movement of the rod in the direction of either of said switches actuates the same, and by means of circuitry, immediately directing the reversible motor to change its direction of turning, which consequently reverses the movement of the plunger within the syringe. Concurrent with the signalling of the motor, the initiation of one or the other of the microswitches also commands drive means, a rack and pinion combination that is energized by means of a solenoid, to effect a turning of a series of gear means incorporating an indexing device which is coupled to the valve that integrally includes a series of passages that direct the flow of blood fluid into or out of the syringe, as during operation of its plunger. This valve comprises both a casing having a cavity formed within one side, wherein a rotary member, which couples to the indexing device, is disposed for periodic turning a certain number of degrees so as to provide for the timed opening or closing of select passages in the ports leading into the valve and their sequential communicating with the interior of said syringe.

In the operation of this blood exchanging device, the movements of the plunger within the syringe are timed with the setting and resetting of the valve so that in a sequence, blood may be first withdrawn from the bloodstream of the body, this withdrawn blood discharged, with the immediately subsequent supply of specified blood infused back into the body to replace the withdrawn toxic blood. This process is performed, as previously described, through the sequence of operations that are controlled by the circuitry and particular switches that are adjustably set to be actuated by movements of the carriage upon and by means of the feed screw, with the actuation of either microswitch immediately instructing the motor to reverse its direction of rotation, and to command the drive means to instantaneously effect a, for example, quarter turning of the rotary member of the valve so that the next passage of the valve may be disposed in open communication with the interior of the syringe to effect either of the blood transferring functions as previously described. Hence, through the arrangement of the interrelated components contained in this apparatus. and their functioning in the sequence of operations as previously described, a blood exchanging device is herein presented that provides for complete and total automation of this blood handling procedure, which heretofore normally commanded the attention of a staff of medical personnel to perform. In this manner, not only is the blood exchanging function reduced to a mechanical operation, but the human element. including its incidence of error, is almost totally circumvented.

BRIEF DESCRIPTION OF THE DRAWINGS In the drawings,

FIG. 1 provides a side view of the entire blood exchanging apparatus of this invention;

FIG. 2 discloses a plan view of the invention,

FIG. 3 is an elevational sectional view taken along the line 3-3 of FIG. 2, showing the syringe coupled to the valve means and the gear means that cooperate to reset the valve repeatedly during a cycle of operation;

FIG. 4 is a sectional view taken along the line 4-4 of FIG. 2 disclosing the solenoid actuated rack and pinion combination useful for driving the gearing that resets the valve during each cycle of operation;

FIG. 5 is a sectional view taken along the line 5-5 of FIG. 3, disclosing the indexing member that couples with the rotary valve of this invention;

FIG. 6 is a sectional view taken along the line 6-6 of FIG. 3, showing the ratchet wheel that is interruptedly turned a fixed number of degrees by means of a pawl and subsequently held in place by means of the detent as shown, all for the purpose of resetting of the valve means;

FIG. 7 is a sectional view taken along the line 77 of FIG. 3, showing the cam and follower components that cooperate with the indexing member to limit the degree of turning of the valve rotary member, in this particular instance, to a quarter turn;

FIG. 8 is a sectional view also taken somewhat along the line 5-5 of FIG. 3, showing all of the previously described components in FIGS. 5 through 7, being mounted together to form an assembled gear means for driving the rotary member of this invention, as when it is being turned a fixed number of degrees;

FIG. 9 is a partial sectional view taken along the line 99 of FIG. 2, showing the carriage of this invention disposed in operation for rolling along the base of the device, while also shown in hidden line the same carriage as when it is pivoted upwardly and away from its connection to the plunger of the syringe and its mated threaded engagement upon the feed screw,

FIG. 10 provides a view of the valve means of this invention in operation as when its rotary member is set to allow a supplying of new blood into the syringe;

FIG. 11 is a view of the valve member of this invention with its rotary member being set to effect passage of the new blood contained in the syringe for transfer into the bloodstream of the recipient;

FIG. 12 provides a horizontal sectional view taken through the valve means of this invention showing its rotary member being withdrawn from the cavity of the valve casing;

FIG. 13 provides an end view of the valve casing taken along the line l3 13 of FIG. 12;

H6. 14 provides an end view of the rotary member of the valve taken along the line 1414 of P16. 12;

H6. provides an elevational view taken along the line 15-15 of FIG. 2, showing part of the stabilizing rod and the disposition of one of its spring loaded ends in relation to a microswitch;

FIG. 16 is a vertical sectional view taken along the line 16- 16 of FIG. 1, showing the clamp that supports the syringe upon the base of the device; and

FIG. 17 provides a schematic circuit diagram showing the electrical relationship between the various relay and switches that function to achieve the sequence of operations of the reversing motor and solenoid included within the system for automating this blood exchanging device.

DESCRIPTION OF THE PREFERRED EM BODIMENT The preferred embodiment of this invention is disclosed in full in FIGS. 1 through 3, wherein there is shown the apparatus A which basically comprises an adapted medical syringe 1 being of tubular form which is held by means of an adjustable clamp 2 to the base 3 of said device. This clamp 2 is adjustable, heightwise, by means of a nut 4, with the tension of said clamp being tightened by means of the adjustment of a screw 5, disposed laterally of the clamp. See also FIG. 16. As usual, the syringe contains an internal longitudinally sliding plunger 6 that is provided at its back end with a lip 7 which is engageable by a slide coupling 8 that is formed integral with a carriage 9 which upon operation of the device provides for the longitudinal shifting of said plunger within its syringe. As also disclosed in FIG. 9, this carriage, along one edge, is pivotally and slidably mounted to a stabilizing rod 10, and disposed adjacent to said rod is a threaded feed screw 11, which is provided for threadedly engaging with a half nut like con figuration, as at 12, which is integrally formed upon a portion of the underside of said carriage. To facilitate the threaded engagement of this half nut portion of the carriage upon the feed screw as during operation of this exchanging device, the carriage is provided with a weighted portion 13 which urges the carriage downwardly, and provided below the weighted portion is a roller 14 disposed for riding upon the base 3 of the device so as to facilitate this longitudinal shifting, in either direction, of said carriage, and the coupled syringe plunger. The purpose for providing this pivotal movement to the carriage 9 about the rod 10 is twofold, first to provide a method for disengagement of the nut 12 from upon the feed screw 11, but also to make provision for disengagement of the slide coupling 8 from the lip portion 7 of the syringe plunger, as when it is desirable to remove or replace said syringe.

This feed screw 11 is disposed for rotatable movement, in either direction, within a pair of mounts l5 and 16. and a shaft 17 integrally extending from one end of said feed screw is coupled to a gear 18 which in turn is engaged with a speed reducing intermediate gear 19 that mates with a gear 20 provided on the end of a reversible motor 21. See again FIG. 2. Obviously, it can be seen that upon the turning of said motor in either direction, the feed screw 11 will also rotate in either direction accordingly. This motor is mounted upon the base 3 and within a housing 22 which also provides shelter for the various relay assembly 23, and the electrical circuit and control panel 24 which is useful for controlling the sequence and cycle of operations of this blood exchanging device, and whose operations will be subsequently described in greater detail. Electrical energy is supplied to both the motor and the circuitry of the device through an electrical cord and plug 25.

As previously described, a slide rod 10 is disposed parallel and adjacent to the feed screw 11, and said rod is also mounted through spring loaded connections to the mounts 15 and 16 at either of its ends. See also FIG. 15 for one such connection. Each of these spring loaded connections are similar, and comprises the end of the rod 10 having a reduced and integral extending portion 26 that is disposed through an aperture, as at 27, provided in each of said mounts 15 and 16, with a spring 28 being disposed between the shoulder portion 29 of said rod and the side of the said mounts, as shown. A shield 30 is provided over each of the springs 28. In this manner, the two spring loaded ends of the rod maintain said rod normally at rest equally spaced between the two mounts 15 and 16. but that whenever the carriage 9 encounters one or the other of a pair of adjustable stops 31 and 32, manually fixed upon said rod 10, then the feed screw urged carriage 9 will push against its proximate and contiguous stop to urge the rod 10 against the bias of its spring 28 to force it into contact with either the microswitch 33 or 34, and cause their actuation depending upon which way the rod 10 is being urged. Electrical wiring, as herein shown covered by the insulating conduit 35, connects each of these microswitches 33 and 34 within the circuitry of this device, their functioning of which may be more easily described in a subsequent review of the operation of this device.

A drive means 36 engages with gear means 37, which during actuation. provides for the setting and resetting of a valve 38 that is coordinated with the operations of the syringe to provide for both the drawing and ejecting of blood into and from the said syringe member. See FlG. 2. By also referring to FIG. 4, the drive means and part of the gear means useful for actuating the valve are more accurately disclosed. Said drive means comprises a solenoid 39, which is mounted upon the base 3, said solenoid being electrically connected with the circuitry encased within the insulator 35, which thereby also electrically connects said solenoid with the timing of the operation of the motor and responsive to the actuations of each of the microswitches 33 and 34. The movable core 40 of the solenoid connects with a rack bar 41 having the usual series of teeth 42 provided upon its upper surface, and disposed for engaging with the teeth of a pinion 43. The core 40 of the solenoid is normally withdrawn within the same, but upon its actuation, said core is urged outwardly, causing the rack to shift laterally and effect a turning of its mating pinion. But, when said solenoid is de-energized, a spring 44 which has been forced into compression due to a shifting of the rack, returns the rack to its normal position. A casing 45 is secured by means of fasteners 46 to one of the frames 47 that stably support the gear means upon the base 3. By referring to FIG. 3, it can be seen that the pinion 43 can be manually turned by means of the manipulation of a knurled knob 48 which is secured to a shaft 49 which is bearing mounted for ease of rotation by means of the bearings 50, with said shaft being secured to said pinion by means of a set screw 51.

Further included within the gear means 37 of this invention is a camming member 52 which is formed integral with the pinion 43, or is rigidly attached thereto for simultaneous pivotal movement. See also H0. 7. As stated, this cam is disposed for limited pivotal movement, and the limits of itsmovement are controlled by means of a pin 53 that projects from the frame 47, while the extent of pivoting of said cam is regulated through an adjustable stop 54 which is disposed for contacting the edge 55 to preclude further rotation of said cam. See FIG. 6.

Disposed for rotation with respect to the other frame 56 supporting said gear means, is a ratchet wheel 57 which is disposed in sliding engagement partially within the camming member 52. This ratchet is rigidly mounted upon a sleeve 58 which is also rotatably mounted within the structure of the frame 56, and further connecting to said sleeve is an indexing member or plate 59 which has secured to it a rotatable sleeve like portion 60. Both the indexing plate and this sleeve like portion 60 are held secure to the sleeve 58 by means ofa set screw 61.

Pivotally mounted to the frame 47, or more particularly to its integral extending portion 62, is a latch 63, which has a bearing mounted cam follower 64 secured thereto, and which cam follower is disposed for riding upon the surface of the cam 52. A spring 65 normally biases the follower into contact with the camming surface 52. and upon rotation of said cam, and due to the tapering contour of its surface, the leading edge of the latch 63 will be periodically elevated or lowered respectively out of or into engagement with the slots, as at 66. provided upon the marginal or peripheral edges of the indexing plate 59. See FIG. 5.

Periodic and interrupted rotation of the ratchet wheel 57, its sleeve 58, and the indexing plate 59 is achieved by means of a pawl 67 which is pivotally mounted to the side of the cam 52, and is spring loaded, by means of the leaf spring 68 so that the tooth of said pawl may be continuously urged into contact with the teeth of said ratchet wheel. See again FIG. 6. Obviously, as the camming member 52 is pivoted a fixed distance, as due to a manual turning of the knob 48, or through the operation of the drive means 36, this pawl 67 engaging with the teeth of the ratchet wheel 57 will also cause its simultaneous pivot a fixed number of degrees. FIG. 8 shows these components in pivotal movement. To prevent a reverse rotation of the ratchet wheel 57 as when the cam and the pawl 67 are returned to rest at their normal position, a detent 69 also mounts to the frame 47, and is spring loaded by means of the leaf spring 70 to engage the proximate teeth of the contiguous ratchet wheel and preclude its rotation in the opposite direction, once it has been turned and set to a particular position by means of the operation of said pawl. During this function, the follower 64 of the latch 63 initially rises to disengage the end of said latch from the indexing plate 59, due to the movement of said follower upon the camming surface, but that during the continued pivot of said cam the follower eventually provides again for a lowering of its latch for eventual engagement with the next succeeding slot 66 of the simultaneously pivoting indexing plate 59. When the latch engages the next slot 66 in the indexing plate, further pivot or rotation of either said indexing plate or the ratchet 57 is precluded, with the drive means 36 being de-energized to allow for the bias of the spring 44 to provide for a return of the cam 52 and pawl 67 to its normal position, while the detent 69 fixes the ratchet wheel 57 and indexing plate in place.

The frontal portion of the sleeve 58 is provided with a transverse like tongue 71, which is disposed for mating within a transverse slot 72 provided across the back end of a rotary member 73 which comprises a part of the valve 38. See FIGS. 3 and 12. This valve 38 is essentially constructed of a casing 74 having a cavity 75 provided into its back side, wherein the rotatable member 73 inserts, and is provided with a fluidic seal by means of an O-ring 76 in order to maintain the rotatable member 73 securely within the casing 74, and particularly when the same is being rotated by operation of the gear means 37, a spring loaded rod 77 is disposed for longitudinal movement within the sleeve 58, and is urged against the end of the rotatable member 73, thereby forcing its disposition within the cavity 75 of said valve casing.

By continuing to refer to FIG. 12, it is to be noted that this rotatable member 73 itself is provided with an internal cavity 78, and when this rotatable member is snugly engaged within the cavity 75 of the casing 74, to further augment its proper seating, a stem 79 extends integrally centrally out of said cavity 75 of the casing and becomes disposed within the cavity 78 of said rotatable member 73. Extending from the front side of said valve casing 74 is a nipple 80 which is provided with projecting large pitched threads 81 to which the discharge end 82 of the syringe couples.

By referring once again to FIG. 3, as well as FIG. 2, there is shown means for retaining these various portions of the valve together, such as the rotatable member properly seated within the cavity of the casing, as when the device has been set up for operation. As shown also in FIG. 12, the sides of the valve casing are provided with vertical slots 83 which are disposed for mating engagement with a pair of vertical rails 84, formed integral with a bracket 85 which is disposed for longitudinal sliding upon a shaft 86, as when a knurled knob 87 is rotated to disengage a bayonet lock 88 to provide for a rearward pulling of said rails and bracket so as to pull the valve, including its rotatable member 73, free from its engagement with the tongue 71 within the sleevelike portion 60 of the device. Once this procedure is followed, and the syringe discharge end 82 has been disengaged from the nipple 80, the entire valve may be raised from disengagement within the rails 84, free for either cleaning or disposal as desired. Structural support for this shaft 86 is provided through its slide mounted securement to both of the frames 47 and 56 of the gear means 37.

The regulation of the flow of blood fluid from the syringe and through the valve is achieved through the sequential rotation of said rotatable member 73 within the valve casing 74. A series of passages are provided for fluid communication between said rotatable member and the casing, with the main passage 89 providing fluid communication between the interior of said syringe and into the valve. By referring to FIG. 13, there are shown various passages within the valve casing, such as the passage at 90 that leads up to a port 91 which connects to a conduit 92 that has attached at its other end, not shown, a needle or the like which may be inserted for fluid communication within the umbilical vein of the body, for the purpose of withdrawing of blood fluids. A second passage 93, which, just as passage 90, opens into the cavity of the valve casing, is in communication with a port 94, which has connected thereto a conduit 95 which normally empties within a means to provide for accumulation and disposal of withdrawn deleterious blood from the body. An additional passage 96 is in communication with a port 97, which has connected thereto a conduit 98 which is normally in fluid communication with a vessel containing a fresh supply of specified blood which has been selected for medical purposes to be infused into the body of the patient. A final passage 99 is connected by means of a slot 100, and to the passage 90, and eventually the conduit 92, which provides for passage of the specified blood from the syringe through the conduit 92 for infusing into the body. The arrangement of these various passages 90, 93, 96 and 99, as opening into the cavity 75 of the valve casing 74, are disposed for periodic and timed opening as during the sequence of operation of this blood exchanging device. To achieve this, the rotatable member 73 of the valve, as shown in FIG. 14, is provided with an annular passage 101 formed around the edge of its cavity 78, and from one side has a radial slot 102. which annular passage 101 is constantly in fluid passing communication with the conduit or passage 89 leading directly from the interior of the syringe, with the slot 102 periodically coming into fluid passing communication with the various passages 90, 93, 96 or 99, as when said rotatable member is periodically rotated by means of the gear means.

A circuit useful for providing the electrical operation of this blood exchanging apparatus is disclosed in FIG. 17. As shown, electrical charge of approximately 120 volts, 60 cycle alternating current is supplied to the circuit through the lines 103 and the ground line 104. A line switch 105 provides for the manual initiation of the apparatus. Also, a neon light 106 indicates when the apparatus has been energized by the power supply. The armature of the reversing motor 21 is connected within the circuitry of the apparatus, and its control, and more particularly, its direction of rotation, is achieved through the series of contacts 107 and 108, of the main relay 23 of the apparatus, as previously described, with the setting of the contacts of the relay 23 being achieved through the closing of the contacts of the microswitches 33 and 34, as through the longitudinal shifting, in one or the other direction, of the rod 10, with the closing of either one or the other of said microswitches providing for the energization of the coil 109 of the relay 23, and the coil 110 of the solenoid 39. During operation of the apparatus, the motor may be manually reversed in its turning by means of the closing of a reversing switch 111 so as to cause the exchanging apparatus to immediately reverse its operation, even though it may have been just previously set to perform an opposite function, such as to withdraw blood rather than to infuse a supply of it into the body. Furthermore, within the operation of the relay 23, there is included another switch 112 which is also actuated by the relay coil 109, so that when one or the other of its contacts are closed, and indicator light 113 will glow to indicate the infusion of blood into the body, while the alternate glowing of the light 114 will indicate the withdrawal of blood from the body.

Motor control, and its speed of operation under increased loads, is achieved through the use of a silicon controlled rectifier (SCR) 115 and a series of potentiometers 116 and 117. During the positive half cycle of the supply voltage, the arm of the potentiometer 116, which may have a capacity of 500 ohms, 2 watts, taps a fraction of the sine wave supply voltage and compares this with the counter EMF of the motor through the gate 118 of the SCR 115. When the potentiometer voltage rises above the armature voltage, current flows through the diode 119 and to the gate 118 of the SCR triggering it, and thus supplying the remainder of that half cycle of voltage to the motor. As a result, the speed of the motor tends to decrease, thus decreasing the counter EMF in proper proportion to the speed. The sine wave potential voltage thus causes current to flow into the SCR gate at an early stage in the cycle of operation of the motor, and thus additional voltage is supplied to the armature to compensate for the increased load, as for example, when the feed screw is urging the plunger of the syringe to infuse a supply of blood into the body. Furthermore, in this manner the preset speed of the device is maintained, which is selected through an adjustment of the potentiometer 116. This diode, or rectifier 119, prevents excessive reverse voltage on the gate 118 of the SCR. Diode 120 prevents the inductive field current in the motor from having adverse effects upon the SCR circuit, and the resistor 121, which may be in the vicinity of l kilo-ohm, and the capacitor 122 improves stability in the circuitry. Contacts 107a and 1080 cause the motor to rotate in a clockwise direction, while contacts 107!) and 10% of the relay 23 cause the motor to rotate in an opposite direction. This is achieved by feeding a pulsating DC voltage to the motor and reversing its field, and all of this is effected when the microswitches 33 and 34 are alternately closed so as to energize the coils 109 and 110.

In the operation of this blood exchanging apparatus, and during its process of usage, a sterilized or fresh syringe will be inserted into the clamp 2, with the lip 7 of the plunger of said syringe being inserted in place within the slide coupling 8 of the carriage 9. Furthermore, the discharge end 82 of said syringe will be coupled to the nipple portion of the valve 38, and the apparatus will be operated and set so that the plunger will be inserted fully within its syringe 1. Following this, the conduit 92 connecting with the port 91 of the valve will be inserted into communication with the bloodstream of the body, such as through the umbilical vein. The conduit 95 connecting with the port 94 of the valve will be coupled to a disposal vessel, and the conduit 98 connecting with the port 97 of said valve will be in communication with a fresh supply of medically specified blood that is to be infused into the body of the patient being treated. Then, the valve will be adjusted so that the slot 102 of the rotatable member 73 will be in communication with the passage of the valve, and the indexing plate may be numbered as shown in FIG.

l, to indicate the present setting of the valve. The motor is then energized to effect a rotation of its feed screw 11 and a retracting of the carriage 9 and the plunger of the syringe so as to withdraw the desired quantity of blood from the body, this quantity being gauged and maintained through the proper setting of the stops 3] and 32 upon the stabilizing rod 10, and this operation is continued until the carriage encounters the stop 31 and forces the proximate end of said rod into contact with the microswitch 33, closing the same, which then energizes both the coils of the relay 109 and the solenoid 110, as shown in the circuit diagram. As a result of this, the relay coil is energized so as to effect a closing of its contacts 107a and 108a, thereby causing the reversing motor to rotate in a counterclockwise direction, and changing the direction of rotation of the feed screw. Simultaneously, the solenoid coil 110 is energized so as to effect a drawing of its rack 41 causing the gear means to function to pivot the rotatable member of the valve approximately a quarter turn, to thereby set its slot 102 in communication with the passage 93 of the valve. As now set, the plunger is forced inwardly of its syringe by operation of the feed screw, with the just previously withdrawn blood being discharged through the conduit 95 and to an area of disposal. This process continues until the carriage 9 encounters the stop 32, which induces a slight longitudinal shift of the rod 10 and a closing of the microswitch 34 effecting once again an energization of both the relay and solenoid coils, thereby causing the relay contacts [07b and 108b to be closed, and reversing the turning of the feed screw once again into a clockwise direction. Simultaneously, the rack is again shifted so as to cause the gear means to effect another quarter turn of the rotatable member of the valve to place its slot 102 into communication with the passage 96 of said valve. This setting is shown in FIG. 10. As the plunger is once again withdrawn from its syringe, a fresh supply of medically specified blood will be drawn into the syringe through the conduit 98, until such time as the carriage once again communicates with the stop 31, thereby reversing the feed screw, and causing the solenoid to rotate the rotatable member approximately another quarter turn, whereby the fresh supply of blood contained in the syringe will be forced outwardly by means of the plunger to flow through the passage 99 and groove 100 and into the passage 90 and conduit 92 for its injection into the body. This arrangement is shown in FIG. 11. Thus, it can be seen that this blood exchanging device can operate in total automation after it has been initially set by a nurse or other medical personnel.

After completion of a blood exchanging operation, and after all of the various conduits have been removed from their respective settings, the knob 87 may be turned to effect a disengagement of the bayonet lock 88, and withdrawn so as to free the entire valve from the gear means, the discharge end of the syringe may be disengaged from said valve, and the valve then taken from the apparatus and disposed of or sterilized as desired. And, although it is not shown in the drawings, a counter may be intergeared with the gear means 37 and triggered upon a complete rotation of the, for example, ratchet wheel 57, so as to indicate the number of cycles of operations achieved by this device, for a rapid determination of the precise quantity of blood that has been exchanged in the body of the patient.

Numerous variations in the construction and method of use of this blood exchange apparatus, within the scope of the appended claims, may occur to those skilled in the art in light of the foregoing disclosure. The described embodiment is merely illustrative.

Having thus described the invention, what is claimed and desired to be secured by Letters Patent is:

1. In a blood exchanging apparatus for use in sequentially removing and discharging a quantity of deleterious blood fluid from the body, with the immediate supplying and infusing of an approximately equivalent quantity of medically specified blood fluid into the body comprising, a syringe means having a discharge end disposed for alternately drawing and ejecting a quantity of blood, valve means connecting with said syringe and operatively providing the regulation of fluid passage with respect to said syringe in the removing, discharging, supplying and infusing of said quantities of blood, a conduit connected to said valve means and adapted to be connected to the body communicating with the blood stream therein, said valve provided with a series of ports, a first port providing the means for connecting the conduit that provides for the removal and infusing of blood from and into the blood stream of the body, a second port providing for supplying for discharge of the removed blood, and a third port providing for supplying specified blood to the syringe means for its infusion into the body, drive means operatively engaging said syringe providing for its actuation during performance of the aforesaid sequence of blood handling functions, said valve means being selectively and timely changeable in its fluid passing settings in response to the operations of said means during its actuation of said syringe, said valve means comprising a casing having said series of ports integrally formed therewith, means for mounting said casing within the apparatus, said casing having an annular cavity formed therein, means for connecting the discharge end of the syringe to the casing side opposite the location of its formed cavity, therebeing a passage formed through said casing to provide communication between the syringe discharge end and into the casing cavity, therebeing a series of passages providing communication between said ports and opening into the casing cavity, a rotatable member disposed for periodic rotation within the casing cavity, said member forming a fluidic seal with the casing, therebeing a fluid passing groove formed upon the surface of the rotatable member disposed within the casing with said groove being in constant communication with the passage from the discharge end of the syringe, said groove capable of periodic arrangement in communication with one of said port passages, and indexing means operatively associated with said rotatable member and provided for interrupted rotation thereby furnishing pivotal movement to said rotatable member of the valve means, separate drive means upon actuation provided for functioning of said indexing means, and said separate drive means being responsive to the limits of movement of the means actuating the syringe during performance of the sequence of blood handling functions.

2. The blood exchanging apparatus of claim 1 wherein the valve means is removably mounted in the apparatus.

3. In a blood exchanging apparatus for use in sequentially removing and discharging a quantity of deleterious blood fluid from the body, with the immediate supplying and infusing of an approximately equivalent quantity of medically specified blood fluid into the body comprising, a syringe means having a discharge end disposed for alternately drawing and ejecting a quantity of blood, valve means connecting with said syringe and operatively providing the regulation of fluid passage with respect to said syringe in the removing, discharging, supplying and infusing of said quantities of blood, a conduit interconnecting between said valve means and the body communicating with the bloodstream therein, said valve provided with a series of ports, a first port providing the means for connecting the conduit that provides for the removal and infusing of blood from and into the bloodstream of the body, a second port providing for discharge of removed blood, and a third port providing for supplying specified blood to the syringe means for its infusion into the body, means operatively engaging said syringe providing for its actuation during performance of the aforesaid sequence of blood handling functions, said valve means being selectively and timely changeable in its fluid passing settings in response to the operations of said means during its actuation of said syringe, said valve means comprising a casing having the series of ports integrally formed therewith, means for mounting said casing within the apparatus, said casing having an annular cavity formed therein, means for connecting the discharge end of the syringe to the casing side opposite the location of its formed cavity, there being a passage formed through said casing to provide communication between the syringe discharge end and into the casing cavity, there being a series of passages providing communication between said ports and opening into the casing cavity, a rotatable member disposed for periodic rotation within the casing cavity, said member forming a fluidic seal with the casing, there being a fluid passing groove formed upon the surface of the rotatable member disposed within the casing with said groove being in constant communication with the passage from the discharge end of the syringe, said groove capable of periodic arrangement in communication with one of said port passages, gear means engaging said rotatable member and which upon turning providing for its rotation and the sequential functioning of the blood exchanging device, said gear means including a supporting frame, an indexing member engaging with said rotatable member and mounted for interrupted rotation upon said frame, a ratchet wheel supported by said frame for fixed rotation with respect to said indexing member, a camming member mounted for limited pivotal movement upon said frame and being disposed adjacent to said ratchet wheel, a latch pivotally connecting to said frame and arranged for mating engagement with said indexing member to interrupt its rotation, a follower bearing mounted to said latch and being in contact with said camming member, the pivoting of said cam providing for disengagement and engagement of said latch with said indexing member, a pawl being attached in restraint movement with respect to said camming member while being urged into engagement with said ratchet wheel, the pivoting of said camming member in one direction providing for the limited rotation of said indexing and rotatable members through the agency of said pawl, a detent attached in restraint movement with respect to said frame and engaging with said ratchet to prevent the turning of said indexing and rotatable members in the opposite direction, and drive means upon actuation providing for the limited pivotal movement of said camming member and pawl.

4. The invention of claim 3 and further including a pinion connecting to said camming member, said drive means including a solenoid responsive to the functioning of the means engaging and actuating said syringe, a rack operatively mounting to said solenoid and shiftable in response to the energization of said solenoid, said rack intergearing with said pinion and functioning to induce the periodic rotation of said rotatable member into the functional settings of said valve means for regulating the blood passage through the connecting syringe.

5. In the process of automatically exchanging of deleterious blood fluid in the body with a like quantity of medically specified blood comprising connecting a syringe incorporating therein a longitudinally slidable plunger with a valve having a series of passages for alternately communicating with the bloodstream in the body, the discharging of withdrawn deleterious blood, and a supply of said specified blood to be infused into the body to replace the withdrawn blood, coupling said syringe plunger to a carriage that threadedly engages to a feed screw turned alternately in either direction through the agency of a reversible motor, arranging a pair of switch means for selective actuation at the preset limits of movement of said carriage in either direction upon said threaded feed screw, setting said valve to that passage that provides for communication with the bloodstream in the body, energizing said motor to effect a turning of said feed screw in a first direction for drawing of said plunger in the syringe to achieve a simultaneous withdrawal of a quantity of deleterious blood from the body, continuing the movement of said carriage upon the feed screw until the first of said switch means is actuated whereupon a drive means is energized to reset said valve to that passage providing for the discharge of withdrawn blood while the motor is simultaneously reversed to turn said feed screw and move said carriage and plunger in the opposite direction, continuing the movement of said carriage upon said feed screw in effecting discharge of said blood until the other switch means is actuated whereupon said drive means is initiated to reset said valve to that passage providing for a drawing of specified blood into the syringe while the motor is reversed to turn said feed screw and move said carriage and plunger again in the first direction, continuing the movement of said carriage upon the feed screw in the drawing of specified blood into the syringe until the first switch means is again actuated whereupon said drive means is initiated to reset said valve to that passage which communicates with the bloodstream in the body while the motor is simultaneously reversed to turn said feed screw and move said carriage and plunger again in the opposite direction to infuse the specified blood into the body, repeating the sequence of movements of said carriage upon said feed screw in alternate directions for repeated actuations of said switch means to continue the cycle of withdrawing, discharging, supplying and infusing blood from and into the body until a predeter- UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Patent No. 3.701 .350 Dated October 31, 1972 Inventoflg) Harvey C Guenther I It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

In claim 1, column 12, lines 27 and 28, cancel "supplying for".

Signed and sealed this 1st day of May 1973.

(SEAL) Attest:

EDWARD M.FLETCHER,JR. ROBERT GOTTSCHALK Attesting Officer Commissioner of Patents FORM o-Ioso (\o-ss) USCOMWDC wwlhpm i U.5. GOVERNMENT PRINTING OFFICE I I," O-lCO-QSI. 

1. In a blood exchanging apparatus for use in sequentially removing and discharging a quantity of deleterious blood fluid from the body, with the immediate supplying and infusing of an approximately equivalent quantity of medically specified blood fluid into the body comprising, a syringe means having a discharge end disposed for alternately drawing and ejecting a quantity of blood, valve means connecting with said syringe and operatively providing the regulation of fluid passage with respect to said syringe in the removing, discharging, supplying and infusing of said quantities of blood, a conduit connected to said valve means and adapted to be connected to the body communicating with the blood stream therein, said valve provided with a series of ports, a first port providing the means for connecting the conduit that provides for the removal and infusing of blood from and into the blood stream of the body, a second port providing for supplying for discharge of the removed blood, and a third port providing for supplying specified blood to the syringe means for its infusion into the body, drive means operatively engaging said syringe providing for its actuation during performance of the aforesaid sequence of blood handling functions, said valve means being selectively and timely changeable in its fluid passing settings in response to the operations of said means during its actuation of said syringe, said valve means comprising a casing having said series of ports integrally formed therewith, means for mounting said casing within the apparatus, said casing having an annular cavity formed therein, means for connecting the discharge end of the syringe to the casing side opposite the location of its formed cavity, therebeing a passage formed through said casing to provide communication between the syringe discharge end and into the casing cavity, therebeing a series of passages providing communication between said ports and opening into the casing cavity, a rotatable member disposed for periodic rotation within the casing cavity, said member forming a fluidic seal with the casing, therebeing a fluid passing groove formed upon the surface of the rotatable member disposed within the casing with said groove being in constant communication with the passage from the discharge end of the syringe, said groove capable of periodic arrangement in communication with one of said port passages, and indexing means operatively associated with said rotatable member and provided for interrupted rotation thereby furnishing pivotal movement to said rotatable member of the valve means, separate drive means upon actuation provided for functioning of said indexing means, and said separate drive means being responsive to the limits of movement of the means actuating the syringe during performance of the sequence of blood handling functions.
 2. The blood exchanging apparatus of claim 1 wherein the valve means is removably mounted in the apparatus.
 3. In a blood exchanging apparatus for use in sequentially removing and discharging a quantity of deleterious blood fluid from the body, with the immediate supplying and infusing of an approximately equivalent quantity of medically specified blood fluid into the body comprising, a syringe means having a discharge end disposed for alternatelY drawing and ejecting a quantity of blood, valve means connecting with said syringe and operatively providing the regulation of fluid passage with respect to said syringe in the removing, discharging, supplying and infusing of said quantities of blood, a conduit interconnecting between said valve means and the body communicating with the bloodstream therein, said valve provided with a series of ports, a first port providing the means for connecting the conduit that provides for the removal and infusing of blood from and into the bloodstream of the body, a second port providing for discharge of removed blood, and a third port providing for supplying specified blood to the syringe means for its infusion into the body, means operatively engaging said syringe providing for its actuation during performance of the aforesaid sequence of blood handling functions, said valve means being selectively and timely changeable in its fluid passing settings in response to the operations of said means during its actuation of said syringe, said valve means comprising a casing having the series of ports integrally formed therewith, means for mounting said casing within the apparatus, said casing having an annular cavity formed therein, means for connecting the discharge end of the syringe to the casing side opposite the location of its formed cavity, there being a passage formed through said casing to provide communication between the syringe discharge end and into the casing cavity, there being a series of passages providing communication between said ports and opening into the casing cavity, a rotatable member disposed for periodic rotation within the casing cavity, said member forming a fluidic seal with the casing, there being a fluid passing groove formed upon the surface of the rotatable member disposed within the casing with said groove being in constant communication with the passage from the discharge end of the syringe, said groove capable of periodic arrangement in communication with one of said port passages, gear means engaging said rotatable member and which upon turning providing for its rotation and the sequential functioning of the blood exchanging device, said gear means including a supporting frame, an indexing member engaging with said rotatable member and mounted for interrupted rotation upon said frame, a ratchet wheel supported by said frame for fixed rotation with respect to said indexing member, a camming member mounted for limited pivotal movement upon said frame and being disposed adjacent to said ratchet wheel, a latch pivotally connecting to said frame and arranged for mating engagement with said indexing member to interrupt its rotation, a follower bearing mounted to said latch and being in contact with said camming member, the pivoting of said cam providing for disengagement and engagement of said latch with said indexing member, a pawl being attached in restraint movement with respect to said camming member while being urged into engagement with said ratchet wheel, the pivoting of said camming member in one direction providing for the limited rotation of said indexing and rotatable members through the agency of said pawl, a detent attached in restraint movement with respect to said frame and engaging with said ratchet to prevent the turning of said indexing and rotatable members in the opposite direction, and drive means upon actuation providing for the limited pivotal movement of said camming member and pawl.
 4. The invention of claim 3 and further including a pinion connecting to said camming member, said drive means including a solenoid responsive to the functioning of the means engaging and actuating said syringe, a rack operatively mounting to said solenoid and shiftable in response to the energization of said solenoid, said rack intergearing with said pinion and functioning to induce the periodic rotation of said rotatable member into the functional settings of said valve means for regulating the blood passage through the connecting syringe.
 5. In the process of Automatically exchanging of deleterious blood fluid in the body with a like quantity of medically specified blood comprising connecting a syringe incorporating therein a longitudinally slidable plunger with a valve having a series of passages for alternately communicating with the bloodstream in the body, the discharging of withdrawn deleterious blood, and a supply of said specified blood to be infused into the body to replace the withdrawn blood, coupling said syringe plunger to a carriage that threadedly engages to a feed screw turned alternately in either direction through the agency of a reversible motor, arranging a pair of switch means for selective actuation at the preset limits of movement of said carriage in either direction upon said threaded feed screw, setting said valve to that passage that provides for communication with the bloodstream in the body, energizing said motor to effect a turning of said feed screw in a first direction for drawing of said plunger in the syringe to achieve a simultaneous withdrawal of a quantity of deleterious blood from the body, continuing the movement of said carriage upon the feed screw until the first of said switch means is actuated whereupon a drive means is energized to reset said valve to that passage providing for the discharge of withdrawn blood while the motor is simultaneously reversed to turn said feed screw and move said carriage and plunger in the opposite direction, continuing the movement of said carriage upon said feed screw in effecting discharge of said blood until the other switch means is actuated whereupon said drive means is initiated to reset said valve to that passage providing for a drawing of specified blood into the syringe while the motor is reversed to turn said feed screw and move said carriage and plunger again in the first direction, continuing the movement of said carriage upon the feed screw in the drawing of specified blood into the syringe until the first switch means is again actuated whereupon said drive means is initiated to reset said valve to that passage which communicates with the bloodstream in the body while the motor is simultaneously reversed to turn said feed screw and move said carriage and plunger again in the opposite direction to infuse the specified blood into the body, repeating the sequence of movements of said carriage upon said feed screw in alternate directions for repeated actuations of said switch means to continue the cycle of withdrawing, discharging, supplying and infusing blood from and into the body until a predetermined quantity of blood has been exchanged. 